By Linda Huguelet
Chattanooga, TN
@IMFlindaMYELOMA

As the 56th American Society of Hematology (ASH) Annual Meeting approaches, I’ve been busy scouring the abstracts posted on the ASH website in anticipation of learning what is going to be discussed on two topics that are of special interest to me: maintenance therapies and monoclonal antibodies. My goal is to maximize my ASH experience and the knowledge I’m able to absorb and share with others. ASH presentations are presented by researchers and targeted toward doctors, so reviewing as much information as possible in advance will give me a general understanding of the data before hearing the live presentations.

Last year at ASH, maintenance was a major topic and the studies released seemed to confirm that continuous therapy did delay progression of the disease in transplant and non-transplant eligible patients. Data also tended to show that continuous therapy increased overall survival but additional study was needed to more completely confirm this point.

Maintenance strategies are of personal interest to me and I know they are to many of you as well. After my stem cell transplant, it was difficult for me to maintain proper blood counts while on Revlimid maintenance so I chose to discontinue the maintenance after 12 months. Four years after my diagnosis, I recently experienced my first relapse. Once again, I responded very well to a Revlimid (lenalidomide)/Velcade (bortezomib)/dexamethasone treatment regimen and I’m back in remission! I opted to move directly to a maintenance regimen instead of undergoing a second stem cell transplant at this time. I’m trying a maintenance regimen of twice monthly Velcade injections, so I am interested to hear anything and everything about maintenance.
Some of the questions I hope to be able to report back on are:
• Does everyone’s situation require maintenance?
• Do the genomics of the disease influence how maintenance is used?
• How do chromosomal abnormalities influence the selection of medication selected?
• Are there any new treatments or combinations to consider?

A second topic of interest to me is a new class of drugs known as monoclonal antibodies. This class of drug has been used very successfully with some types of leukemia and I hope it will be the same for myeloma. Expanding the number of categories of drugs available to myeloma patients is a significant and exciting prospect. The most recently approved drugs have belonged to the same classes as existing proteasome inhibitors (i.e. Velcade) and IMiDs (i.e. Revlimid), and patients may eventually develop a resistance to these drugs. So adding another class of drug will certainly expand the options for myeloma patients.

Monoclonal antibody research has been talked about at past ASH conferences and the early trials look very promising. A few of the monoclonal antibodies in development that I am watching are SAR 650984, daratumumab, and elotuzumab.

Some of the information I want to be able to report back on is:
• What new data is available from the ongoing clinical trials?
• Do the studies indicate using monoclonal antibodies as single agents or in combination with existing medications?
• If in combination, what are the options showing the best results?
• When will the first monoclonal antibody be presented to the FDA for approval?

Since being diagnosed in 2010, I’ve followed the information coming out of each ASH conference and have always been highly encouraged by the amount of research taking place. Just because myeloma is not what I call a “tier 1” cancer, like breast cancer, it doesn’t mean that research is not actively ongoing to improve the lives of patients and to ultimately find a cure. Being able to attend ASH as a patient representative is a priceless opportunity that will allow me to absorb firsthand all the information and excitement surrounding the advancements in myeloma treatments. As my myeloma journey continues, I’m ever hopeful in the advancements to come and how they may be life-changing for all of us. Please follow me on Twitter as I share my ASH experiences and photos from the conference at @IMFlindaMYELOMA.

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